Avacopan for the treatment of ANCA-associated vasculitis
Tue, 02/23/2021 – 02:00
The ADVOCATE clinical trial evaluated the use of oral avacopan, along with cyclophosphamide or rituximab, as a treatment for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Researchers assembled a study population of 331 participants, randomizing 166 to avacopan and 165 to prednisone taper. At 26-week followup, 72.3% of the avacopan recipients and 70.1% of the prednisone recipients had achieved remission. The outcome was defined as a Birmingham Vasculitis Activity Score of 0, which reflected a drop from a mean score of 16 at baseline. The second primary endpoint was sustained remission—remission at both weeks 26 and 52—which occurred in 65.7% of the avacopan group and 54.9% of the prednisone group. Serious adverse events were documented in 37.3% and 39% of patients, respectively. The findings suggest that avacopan is noninferior, but not superior, to prednisone in achieving remission within 26 weeks but that it was superior to prednisone taper in terms of sustained remission at 1 year.